USA TODAY Guide to Kids' Health magazine features articles to help you raise happy and healthy children. Buy it on magazine newsstands or at kidshealth.usatoday.com. / Cover photo by Brian Bowen Smith

by Ellen Ryan, USA TODAY Guide to Kids' Health

by Ellen Ryan, USA TODAY Guide to Kids' Health

Reminders to "be careful!" seem to go in one ear and out the other as they leap from one precarious situation-scaling a backyard tree, skateboarding down a homemade ramp-to the next.

As a parent, you get used to holding your breath (and crossing your fingers) after witnessing a fall or accident. You wipe the tears and wait to see how much damage was done: Can I patch this up on my own with a few kisses and a Band-Aid, or are we headed to the hospital for professional help?

Here medical experts from around the country look at seven typical household mishaps, weighing in on when you and your injured child should visit the ER.

You're opening the back of the van when your son flies around the corner on his skateboard and his skull hits the liftback. Wham!

YES

The head and neck are high-risk real estate, so don't wait until he passes out to act, says David John, co-chair of emergency services at Johnson Memorial Hospital in Stafford Springs, Conn. And, if there's blood, he may need to get the wound stitched or stapled.

A concussion could cause many things, from a headache and vomiting to death. And head injuries can deteriorate, even if the child is conscious. "It can be dangerous to lie down and sleep with a head injury," says John.

In a situation like this, urgent care may send you on to the ER anyway, which will mean you have two copays to handle. So go to the emergency department right away-because "guessing wrong could be life-threatening," says John.

And next time your son jumps on a skateboard, "I recommend a helmet," he says.

Your preschooler is playing quietly with the dog. Too quietly. They're in the garage munching dry dog food off the oily floor. "I ate a lot," she says happily.

NO

Immediately call your regional poison control center (1-800-222-1222), says Eric Lavonas, associate director of Denver's Rocky Mountain Poison & Drug Center and emergency physician at Denver Health Medical Center. "There are dozens of chemicals in the garage, many of which are very dangerous," he says.

Fortunately, like four out of five kids whose parents call the poison center, your preschooler can safely stay home under your watchful eye. Dog food is safe to eat, and the worst a little motor oil will do is give her a mild stomachache, says Lavonas. "But don't try to figure this out yourself-trained poison specialists know just what to ask" to assess the situation.

To prevent future incidents, make sure bug spray, antifreeze, cleaning supplies and other chemicals are out of reach in the garage and home.

Your husband and son are hammering something on the deck. Suddenly you hear an "Ow!" and words an 11-year-old shouldn't say. Your son's doubled over after a direct whack to his fingernail.

NO

"If it's just painful and swollen, you don't need to do much but ice (it)," says Martha Wilber, associate medical director for hospital and acute care at Kaiser Permanente of Georgia in Atlanta.

Put a few cubes in a plastic bag and hold it around the finger for 10 minutes three or four times for the first 24 hours. "Fingers have a lot of nerves-you feel with them-so if it's throbbing, you can also elevate it above the heart for a while," says Wilber.

If bleeding under the nail becomes very painful, a pediatrician or urgent care physician can drill a tiny hole in the nail to relieve pressure, says Wilber. Severe, ongoing pain can also be a sign of a fracture. Besides ice and acetaminophen, there's not much treatment needed, she says-but having a physician take a look can't hurt.

This is day two of your preteen's headache. She's stayed in bed, has barely eaten and now is vomiting. "My ear hurts," she sniffles.

YES

"Has this child had bad headaches before? If so, she can ride this one out," says Jennifer S. Kriegler, director of the Headache Fellowship Program at the Cleveland Clinic and staff member of its Center for Headache and Pain. "If it's 'the first or the worst,' coming to the ER-not urgent care-is not too drastic."

Why? Doctors may need to do a CT scan (quicker and easier than an MRI) or lab work to rule out bleeding in the brain, meningitis or thyroid disease. Most likely this is a migraine, Kriegler says. But doctors can't say so without more information, and listing your child's symptoms will help.

Your son is heating spaghetti sauce on the stove. As he grabs for a ladle, he bumps the pot and boiling sauce lands on his feet. Ouch!

YES

Probable third-degree burns mean a trip to the ER, says David Greenhalgh, chief of burns at Shriners Hospital for Children-Northern California in Sacramento. Three reasons: "You never know the extent of the damage. There's a significant risk of infection and scarring; it'll be hard to wear shoes if this doesn't heal well. And delaying treatment is a classic sign of an intentional burn or child abuse."

Do not apply ice. Just cover the area loosely with a clean, dry cloth. Going to a pediatrician also works if you trust you can be seen quickly, Greenhalgh says.

You just mopped the kitchen floor when your daughter tries a cheerleading split. Not realizing the floor is damp, she splits a little more than expected. Now she's holding her groin and turning white.

NO

Treat immediately with ice in a wet washcloth, says Marianne Ryan, clinical director of MRPT Physical Therapy in New York City and an orthopedic certified specialist diplomate.

Follow ice treatment with gentle stretches when the pain stops. "A doctor can prescribe anti-inflammatory medications for the strained or torn groin muscle," Ryan says. "The other, preferable course is to see a physical therapist, who may work directly on the muscles to increase flexibility and decrease spasm. Then a progressive exercise program would be used to restore the child to normal function."

If she's in severe pain or there's a bruise or blood, head for the ER.

Your preschooler follows the older kids excitedly as they build their tree fort-until she steps on a nail and shrieks. The nail doesn't look rusty, but â?¦ ?

YES

"Even a nail that looks clean can carry tetanus," says Alan MacGill, a podiatrist in Boynton Beach, Fla. Most kids have had vaccines and boosters, but a 3-year-old is almost due for the next one, "so get to urgent care or the ER to get it addressed."

Two other concerns: A puncture brings in dirt, debris, perspiration and maybe sock and shoe fragments that can cause infection. "Urgent care or the ER can flush out the wound better than you can, and they'll probably give her antibiotics as a precaution," MacGill says.

Also, "the foot is a complex structure-with tendons, ligaments, bones, nerves-and it's hard to see how far the damage goes," he says. Better to have an expert assess it.

When to dial 911

Call 911 "if there's deformity to the bone, a head injury, vomiting (after injury) or a major laceration," says Ryan A. Stanton, director of emergency medicine at the University of Kentucky Good Samaritan Hospital. A minor cut or some pain is probably a matter for an urgent care physician or a pediatrician to address.

Prevention is best

The best way to handle household accidents and emergencies is prevention, says Ryan A. Stanton, president of the American College of Emergency Physicians' Kentucky chapter.

â?¢ Put tamperproof caps in electrical outlets. Secure flat-screen TVs at the base or to the wall. Place knives out of reach. Keep firearms locked and inaccessible.

â?¢ "Look at your whole house from your child's point of view," says Stanton, who notes that his 3-year-old can climb into and onto everything.

â?¢ Check caregivers' homes the same way. When Stanton visits his in-laws, "we move figurines higher and put a towel around the hearth, which has sharp edges."

â?¢ For minor mishaps, have an up-to-date first-aid kit on hand. They're sold preassembled for home, car, camping and other purposes. Add to it anything specific your child might need such as an EpiPen for allergic reactions.

â?¢ Babysitters should be advised to call 911 in an emergency. A medical kit's location "should be part of any babysitter's training," he says.

â?¢ Have a first-aid manual handy, and learn the basics. Courses are available from the American Red Cross, hospitals and perhaps your local first responders. "With kids," says Stanton, "your best course of action is what the Boy Scouts say: Be prepared."

This article is excerpted from USA TODAY Guide to Kids' Health. This special edition magazine contains articles on raising happy and healthy children. Buy it wherever magazines are sold or at kidshealth.usatoday.com.